Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.31 / $59.35 / $111.24	Professional		$41.31	$59.35	$111.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.68 / $25.95 / $117.30	Professional	26	$15.68	$25.95	$117.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.50 / $31.95 / $56.05	Professional	TC	$23.50	$31.95	$56.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.48 / $33.15 / $81.95	Professional		$20.48	$33.15	$81.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.57 / $15.98 / $41.99	Professional	26	$12.57	$15.98	$41.99
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.54 / $20.02 / $33.35	Professional	TC	$19.54	$20.02	$33.35
BCBS Facility/Professional Facility Modifier Low / Median / High Price $98.63 / $98.63 / $98.63	Facility		$98.63	$98.63	$98.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.34 / $37.95 / $94.41	Professional		$33.34	$37.95	$94.41
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $38.36 / $67.77 / $110.96	Professional		$38.36	$67.77	$110.96
Christus Facility/Professional Facility Modifier Low / Median / High Price $44.57 / $62.79 / $66.20	Facility		$44.57	$62.79	$66.20
Christus Facility/Professional Facility Modifier TC Low / Median / High Price $35.94 / $37.59 / $39.79	Facility	TC	$35.94	$37.59	$39.79
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $24.87 / $25.19 / $26.29	Professional	26	$24.87	$25.19	$26.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.44 / $53.43 / $148.66	Professional		$32.44	$53.43	$148.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.14 / $28.37 / $75.09	Professional	26	$13.14	$28.37	$75.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $26.13 / $76.06	Professional	TC	$18.48	$26.13	$76.06
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $211.21 / $379.47 / $379.47	Facility		$211.21	$379.47	$379.47
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $122.45 / $234.18 / $234.18	Facility	26	$122.45	$234.18	$234.18
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $100.79 / $224.87 / $224.87	Facility	TC	$100.79	$224.87	$224.87
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $641.00 / $645.55 / $645.55	Professional		$641.00	$645.55	$645.55
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $513.00 / $513.00 / $513.00	Professional	26	$513.00	$513.00	$513.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $312.17 / $321.52 / $349.13	Professional	TC	$312.17	$321.52	$349.13
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $58.74 / $101.02 / $179.52	Facility		$58.74	$101.02	$179.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $45.38 / $88.65 / $137.28	Professional		$45.38	$88.65	$137.28
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.35 / $38.82 / $63.66	Professional	26	$32.35	$38.82	$63.66
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $49.74 / $59.69 / $87.56	Professional	TC	$49.74	$59.69	$87.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $26.09 / $56.26 / $123.98	Professional		$26.09	$56.26	$123.98
Providence Facility/Professional Facility Modifier Low / Median / High Price $56.74 / $105.66 / $183.20	Facility		$56.74	$105.66	$183.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.90 / $65.66 / $175.87	Professional		$32.90	$65.66	$175.87
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $13.14 / $28.19 / $78.38	Professional	26	$13.14	$28.19	$78.38
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.43 / $25.74 / $73.22	Professional	TC	$18.43	$25.74	$73.22
United Facility/Professional Professional Modifier Low / Median / High Price $41.14 / $61.06 / $154.28	Professional		$41.14	$61.06	$154.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.32 / $28.87 / $68.15	Professional	26	$17.32	$28.87	$68.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.82 / $28.43 / $79.80	Professional	TC	$23.82	$28.43	$79.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $26.74 / $40.98 / $65.70	Professional		$26.74	$40.98	$65.70
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.26 / $22.46 / $26.03	Professional	26	$11.26	$22.46	$26.03
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $15.48 / $21.32 / $39.68	Professional	TC	$15.48	$21.32	$39.68